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在选择性下 inguinal 绕道手术后非家庭出院风险评分的验证
Elizabeth E Raby1, Richard D Gutierrez2, Zachary A Matthay3
1School of Medicine, University of California San Francisco, San Francisco, CA.
Journal of vascular surgery
|February 13, 2025
概括
在下肢旁路术 (LEB) 后,对非家庭出院 (NHD) 的新风险评分得到了外部验证. 这种工具有助于为接受LEB手术的患者提供手术前咨询和出院后规划.
科学领域:
- 血管外科 血管外科
- 医疗保健服务研究 医疗服务研究
- 患者的治疗结果.
背景情况:
- 非家庭出院 (NHD) 对患者的生活质量产生负面影响,并增加医疗保健成本.
- 在下下肢旁路术 (LEB) 后开发了NHD的先前风险评分,但需要外部验证.
研究的目的:
- 通过单一的机构数据,外部验证一种新的风险评分,用于预测下肢下肢LEB后的NHD.
- 在一个新的患者队列中评估现有的LEB NHD风险评分的预测准确性.
主要方法:
- 从单个四元中心电子数据仓库对选修LEB案例 (2012-2020) 的回顾性分析.
- NHD,定义为出院到熟练护理机构或急性康复中心,是主要的终点.
- 应用了先前开发的风险评分,并通过逻辑回归,c-统计和霍斯默-莱梅肖测试来评估其预测能力.
主要成果:
- 在242名患者中,22%的人经历了NHD. 风险评分显示出显著的预测能力 (c-统计:0.702).
- 随着风险类别的不同,NHD率增加了4.0% (低),26.0% (中等) 和34.0% (高).
- 与低风险组相比,较高风险组的NHD几率明显更高 (中等风险OR:8.8;高风险OR:13.0).
结论:
- 新的NHD风险评分在外部数据集中成功验证.
- 这种验证的风险评分可以提高手术前的患者咨询,并优化出院后的规划.
- 建议对NHD风险评分进行前性验证,以便在未来进行研究.
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